By 
When Healthcare Pushes You Over the Edge
By Njeri Jomo, CEO, Jubilee Health Insurance
The Hidden Cost of Illness
Healthcare is often seen as a support system something we turn to in times of need. Yet for many Kenyan families, it becomes a financial cliff. One diagnosis, one accident, or a single hospital visit can push an entire household into crisis. School fees go unpaid, meals are skipped, and assets are sold all to afford care.
The World Health Organization (WHO) defines this situation as catastrophic health expenditure, where medical costs exceed 10% to 25% of a household’s income. In Kenya, this isn’t rare; it’s widespread and quietly devastating.
When Healthcare Becomes a Poverty Trap
Each year, the World Bank estimates nearly one million Kenyans are pushed into poverty due to out-of-pocket health expenses. According to Kenya’s National Health Accounts, households contribute 24% of total health spending well above WHO’s global benchmark of 15%.
A WHO and KEMRI Wellcome Trust study reveals that 13.7% of households in Kenya face catastrophic health costs. The impact is greatest on low-income families, the uninsured, and those battling chronic illnesses. Behind the numbers lie tough choices: treatment or rent, medication or food.
A System Misaligned with Real Life
Kenya has made progress with health policy reforms and infrastructure investments. But our health financing model hasn’t kept pace with how most people live and earn. With over 80% of the workforce in the informal sector, steady contributions to health insurance schemes are often unrealistic.
Meanwhile, diseases have evolved. Noncommunicable illnesses like cancer, diabetes, and hypertension require long-term care. These aren’t emergencies — they demand sustained access and resources, something many households cannot consistently provide.
When Healthcare Pushes You Over the Edge
The Path Forward: Practical, Inclusive Solutions
We must ask harder questions. How can we design health insurance that fits the realities of informal incomes? How do we prevent healthcare from becoming a debt trap? Can we shift toward prevention and early treatment before costs escalate?
Multiple solutions can work together:
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Micro-contributions via mobile money
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SACCO-based health pooling
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Flexible outpatient benefit structures
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Targeted subsidies for the most vulnerable
Some insurers are responding. Microinsurance products with low premiums, simple mobile enrolment, and flexible terms are helping bridge the gap. Still, many remain uninsured or underinsured. Expanding these solutions is vital.
Rethinking Protection
Ultimately, we must change how we measure success. It’s not just about budgets or hospital construction. The real question is simple: Are households protected?
A hospital bill should never mean selling a cow or pulling a child out of school. If it does, then we’re not just managing a health system — we’re watching dignity erode.
Finally, catastrophic health expenditure isn’t only about the cost of medicine. It’s about exclusion from a system that was never designed with everyone in mind. We now have a chance and a responsibility to build differently.
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